Acute appendicitis: pediatric

Case contributed by Dr Alborz Jahangiri


Right sided back pain for 4 days.

Patient Data

Age: 2 years
Gender: Male

The right iliac fossa was examined by graded compression ultrasound.

An enlarged appendix (>6 mm) is seen with distinct wall layers as a blind-ending filled tube arising form the medial aspect of the cecum which was not compressible.

There is also surrounding abnormal echogenic omental fat.

Ileo-cecal lymphadenopathy is also noted.

Case Discussion

Ultrasound is the investigation of choice in young patients being investigated for acute appendicitis.

Graded compression ultrasound is the technique used.

Findings to support the diagnosis are: 

  • aperistaltic, non-compressible, dilated appendix (>6 mm outer diameter)
  • target appearance
  • periappendiceal fluid collection
  • periappendiceal hyperechoic structure
  • echogenic prominent pericaecal fat
  • appendicolith
  • distinct appendiceal wall layers
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Case information

rID: 48029
Published: 15th Sep 2016
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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